Fri Sep 13 2024

93 articles - From Friday Sep 06 2024 to Friday Sep 13 2024

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Am J Gastroenterol

Guidelines in Practice: Alcohol-Associated Liver Disease.

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Gastroenterology

AGA Clinical Practice Update on Integrating Potassium-Competitive Acid Blockers Into Clinical Practice: Expert Review.

BEST PRACTICE ADVICE 8: Clinicians should generally not use P-CABs as first-line therapy in the treatment or prophylaxis of peptic ulcer disease. BEST PRACTICE ADVICE 9: Although there is currently insufficient evidence for clinicians to use P-CABs as first-line therapy in patients with bleeding gastroduodenal ulcers and high-risk stigmata, their rapid and potent acid inhibition raises the possibility of their utility in this population.

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Gastrointest Endosc

American Society for Gastrointestinal Endoscopy guideline on role of endoscopy in the diagnosis and management of solid pancreatic masses: methodology and review of evidence.

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American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the management of chronic pancreatitis: methodology and review of evidence.

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Submucosal injection fluid and tattoo agents.

These may be commercially prepared agents or off-the-shelf materials with or without additives to facilitate visualization. A thorough understanding of the indications, techniques, properties of various agents, costs, and adverse events is necessary in choosing the appropriate materials and technique to optimize lesion resection in EMR and ESD.

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Summary: Guidewires in GI endoscopy.

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Meta-analysis

meta-analyses and systematic reviews

Am J Gastroenterol

TC-325 superiority in Malignant Gastrointestinal Bleeding - An Individual Patient Data Meta-analysis of Randomized Trials.

Interpretation TC-325 appears superior to conventional endoscopic therapy in managing patients with malignant GIB. TC-325 results in improvements in immediate hemostasis, 30-day rebleeding and further bleeding, based on very low-to-low certainties of evidence.

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Clin Gastroenterol Hepatol

The association between obesity and malignant progression of Barrett's Esophagus: a systematic review and dose-response meta-analysis.

Our meta-analysis provides some evidence that obesity as measured by BMI is associated with malignant progression of BE with a dose-response relationship. This finding requires confirmation in future high-quality cohort studies. Future risk prediction models could incorporate measures of obesity to potentially improve risk stratification in patients with BE.

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Gastrointest Endosc

Efficacy of hemostatic powder monotherapy versus conventional endoscopic treatment for nonvariceal gastrointestinal bleeding: a meta-analysis and trial sequential analysis.

In conclusion, HP monotherapy surpassed CET in terms of the initial hemostasis rate and 30-day rebleeding rate for patients with malignancy-related GI bleeding. However, their relative efficacy for non-malignancy-related GI bleeding remains unresolved.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Differences in disease characteristics and treatment exposures between paediatric and adult-onset inflammatory bowel disease using a registry-based cohort.

Paediatric-onset presents with more extensive disease with higher exposures to immunomodulators and biologic therapies than adult-onset IBD.

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Glycaemic control is a modifiable risk factor for hepatocellular carcinoma and liver-related mortality in patients with diabetes.

Glycaemic control is an independent risk factor for HCC and liver-related mortality, and should be incorporated into oncoprotective strategies in the general DM population.

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Low socioeconomic status exacerbates unmet health-related needs in patients with autoimmune hepatitis.

There is a high burden of health-related unmet needs in al patients with AIH that is exacerbated by low SES.

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MASLD in people with HIV exhibits higher fibrosis stage despite lower disease activity than in matched controls.

The NAS and histological drivers of fibrosis (e.g. inflammation and hepatocyte ballooning) are less pronounced in MASLD-PWH, and yet fibrosis stage was generally higher when compared to matched controls with MASLD without HIV. This suggests HIV-specific factors beyond hepatic necroinflammation may contribute to fibrosis progression in MASLD-PWH.

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Trends of chronic liver diseases by income level and socioeconomic factors in the United States: A population-based study.

LIG and MIG in the United States have higher liver disease burdens than HIG, with increasing NAFLD prevalence and lack of decline in current HCV infection prevalence over time as opposed to declining or stable trend in HIG.

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Am J Gastroenterol

Management after obstetric anal sphincter injury: anorectal manometry and symptoms predict long-term fecal incontinence.

Symptoms of anal incontinence and ARM in patients post OASI are both useful to predict subsequent long-term FI with a best-fit cut-off of 59mmHg for anal resting pressure. This provides rationale for routine ARM and accurate symptom assessment in al patients after OASI, to identify high risk groups to follow and treat, and it may assist decision-making regarding mode of subsequent obstetric deliveries.

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Prevalence of Belching Disorders and Their Characteristics in the General Adult Population.

A detailed epidemiology of belching disorders in adults was clarified.

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Primary liver cancer risk and mortality in patients with alcohol-related cirrhosis in England and Denmark: observational cohort studies.

The risk of primary liver cancer was the same in English and Danish patients with ALD cirrhosis, and HCCs constituted 97% of primary liver cancers. Mortality with primary liver cancer was equally high in both countries. Notably, in England, where guidance recommends biannual HCC surveillance with ultrasound, patients with ALD cirrhosis were undergoing fewer than 1 ultrasound scan per year.

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Clin Gastroenterol Hepatol

Impact of time period and birth cohort on the trend of advanced neoplasm prevalence in the 40-49 average-risk screening population.

The prevalence of AN in age 40-54 increased in the Taiwanese population, with a later birth cohort having a higher prevalence of AN. However, the prevalence of AN in age 45-49 increased more remarkably and approximated that in age 50-54, which may justify earlier initiation of CRC screening at age 45.

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Endosc Int Open

Additional over-the-scope-clip closure can shorten endoscopic vacuum therapy for postoperative upper gastrointestinal leakage.

The addition of OTSCs after successful EVT is safe and has the potential to shorten leakage therapy, enabling earlier discharge along with better functional outcomes.

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Efficacy and safety of radial incision and cutting for nonsurgical refractory benign esophageal stricture.

RIC for nonsurgical refractory benign esophageal stricture is an effective and safe treatment option.

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Lymphovascular invasion is a dominant risk factor for lymph node metastasis in T2 rectal cancer.

This was a large study on LNM in T2 rectal cancer which showed that LVI is the dominant risk factor. Moreover, low age constituted an independent risk factor, whereas gender, resection margin, PNI, histologic grade, and mucinous cancer were not independent risk factors of LNM. Thus, these findings may provide a useful basis for management of patients after local resection of early rectal cancer.

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Performance evaluation of endoscopic ultrasonography needles: Experimental study.

The performance of the six needles differed in various ways. Understanding the characteristics of each needle may allow for selection of the appropriate needle for each situation.

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Usefulness of an ultrathin endoscope in esophageal endoscopic submucosal dissection.

Ultrathin endoscopes may be useful for difficult esophageal ESD.

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Validation and efficacy of the Varix Trainer model as a Training device for esophagogastroduodenoscopy.

The VTM1 distinguished varying levels of expertise for al techniques, suggesting that it is a valid tool for assessing endoscope manipulation skill. A short curriculum improved novices' manipulation skills faster than traditional practice.

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Endoscopy

Prospective single-arm trial on feasibility and safety of endoscopic robotic system for colonic endoscopic submucosal dissection.

This first clinical trial confirmed the safety and efficacy of performing colorectal ESD using EndoMaster EASE robotic system (Clinicaltrial.gov NCT04196062).

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Gastroenterology

Healthy first-degree relatives from multiplex families versus simplex families have a higher subclinical intestinal inflammation, a distinct fecal microbial signature, and harbor a higher risk of developing Crohn's disease.

Within FDRs of patients with CD, participants from multiplex families had a 3-fold increased risk of CD onset, a higher FCP, and an altered bacterial composition, but not genetic burden or altered gut permeability. These results suggest that putative environmental factors might be enriched in FDRs from multiplex families.

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UNVEILING CANCER-RELATED METAPLASTIC CELLS IN BOTH HELICOBACTER PYLORI INFECTION AND AUTOIMMUNE GASTRITIS.

Both Hp infection and AIG trigger a diverse array of metaplastic cell types. Identification of a cancer-related metaplastic cell uniquely expressing ANPEP/CD13, present in both Hp- and AIG-induced gastritis, indicates the carcinogenic capacity of both diseases. This discovery can guide early detection and risk stratification for patients with chronic gastritis.

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Gastrointest Endosc

Multimodal Convolutional Neural Network-Based Algorithm for Real-Time Detection and Differentiation of Malignant and Inflammatory Biliary Strictures in Cholangioscopy: a Proof of Concept Study with Video.

Our algorithm distinguishes malignant and inflammatory bile duct lesions in dSOC videos, indicating the potential of CNN-based diagnostic support systems for both, CADe and CADx. The integration of non-image data can improve CNN based support systems, targeting current challenges in the assessment of biliary strictures.

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Prophylactic endoscopic vacuum therapy for stricture prevention following wide-field endoscopic submucosal dissection of superficial esophageal cancer.

The prophylactic combination of EVT and BOT is a novel and promising strategy for reducing post-ESD strictures.

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Safety and efficacy of underwater endoscopic mucosal resection for 10-20 mm colorectal serrated lesions (SEA CLEAR study).

This two-center prospective study demonstrated that UEMR for SLs sized 10-20 mm was comparable to previous conventional endoscopic mucosal resection outcomes.

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Gut

Epidemiology of gastrointestinal cancers: a systematic analysis from the Global Burden of Disease Study 2021.

Although the ASIR of oesophageal, gastric and biliary tract cancer has decreased, the ASIR still increased in colorectal, pancreatic and liver cancer from steatotic liver disease. Public policies are important for controlling gastrointestinal cancers-most importantly, reducing alcohol consumption, hepatitis B immunisation and tackling the burden of metabolic diseases.

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Identification of PRMT5 as a therapeutic target in cholangiocarcinoma.

PRMT5 and MEP50 are frequently upregulated in human CCA, and PRMT5-targeting drugs have significant antitumoural efficacy in clinically relevant CCA models. Our findings support the evaluation of PRMT5 inhibitors in clinical trials, including their combination with cytotoxic and immune therapies.

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Long-term hepatitis B surface antigen response after finite treatment of ARC-520 or JNJ-3989.

Short-duration siRNA treatment suppressed HBsAg expression with a prolonged effect for up to 6 years in some participants.

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Microbiota-induced S100A11-RAGE axis underlies immune evasion in right-sided colon adenomas and is a therapeutic target to boost anti-PD1 efficacy.

Our findings unravelled that dysfunctional goblet cells and consequential bacterial translocation activated the S100A11-RAGE axis in right-sided colon ADs, which recruits MDSCs to promote immune evasion. Targeting this axis by Azeliragon improves the efficacy of immunotherapy in colon cancer.

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Risk of hepatic events associated with use of sodium-glucose cotransporter-2 inhibitors versus glucagon-like peptide-1 receptor agonists, and thiazolidinediones among patients with metabolic dysfunction-associated steatotic liver disease.

In this nationwide cohort study, SGLT-2i was associated with a lower risk of hepatic decompensation events in patients with MASLD compared with TZD, while demonstrating similar effectiveness to GLP-1RA.

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Sphincterotomy for biliary sphincter of Oddi disorder and idiopathic acute recurrent pancreatitis: the RESPOnD longitudinal cohort.

Nearly 60% of patients undergoing ERCP for suspected SOD improve, although the contribution of a placebo response is unknown. Contrary to prevailing belief, duct size and labs are poor response predictors. AP recurrence was common and like observations from prior non-intervention cohorts, suggesting no benefit of sphincterotomy in mitigating future AP episodes.

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Hepatology

Association of hepatitis delta virus infection and hepatocellular carcinoma, hepatic decompensation, all-cause and liver-related death in a national cohort.

In a predominantly U.S born cohort of Veterans, HDV co-infection was associated with an increased risk of liver-related outcomes and all-cause mortality. Our findings support widespread testing for early identification of HDV.

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Central role for cholangiocyte pathobiology in cholestatic liver diseases.

The crosstalk between cholangiocytes and cells of the innate (neutrophils and macrophages), and adaptive (T-cells and B-cells) immune systems is also examined in detail. The information will help consolidate information on this topic, guide further research and potential therapeutic strategies for these diseases.

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Disparity landscapes of viral-induced structural variations in hepatocellular carcinoma: Mechanistic characterization and functional implications.

Additionally, clonal disparity of HBV integration was observed among patients and the higher level of clonal disparity score can indicate poor patients' prognostication. Taken together, our study uncovered the different levels of clonal enrichment of HBV integration, mechanistic insights, and prognostic biomarker signature, to strengthen our understanding in HBV-associated hepatocarcinogenesis.

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Efficacy and safety of infliximab in patients with autoimmune hepatitis.

Our study suggests that infliximab may be an effective and safe rescue therapy in AIH.

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HAF prevents hepatocyte apoptosis and progression to MASH and hepatocellular carcinoma through transcriptional regulation of the NF-κB pathway.

HAF is novel transcriptional regulator of the NF-κB pathway and is a key determinant of cell fate during progression to MASH and MASH-HCC.

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HEAR-MHE study: Automated speech analysis identifies minimal hepatic encephalopathy and may predict future overt hepatic encephalopathy.

Automated speech analysis highly correlated with validated HE tests, associated with MHE, and may predict future OHE. Future research is needed to validate this tool and to understand how it can be implemented in clinical practice.

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HKDC1 promotes liver cancer stemness under hypoxia via stabilizing β-catenin.

Overall, our findings underscore HKDC1 as a prometastatic HK specifically expressed in the malignant compartment of primary liver tumors, thereby providing a mechanistic basis for targeting this enzyme in advanced liver cancer.

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Health-Related quality of life (HRQL) assessments in a 52-Week, Double-Blind, randomized, Placebo-Controlled phase 3 study of resmetirom (MGL-3196) in patients with metabolic dysfunction associated steatohepatitis (MASH) and fibrosis.

MASH/NASH patients with fibrosis improvement or resolution of MASH with resmetirom experienced clinically meaningful and statistically significant HRQL improvements.

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Predictors of long-term clinical outcomes after TIPS: An ALTA group study.

Among patients with early post-TIPS TFS, prognosis and need for LT should be reassessed, informed by post-procedure changes in MELD-Na and clinical status. For selected patients, "destination TIPS" without LT may offer long-term survival with freedom from portal hypertensive complications.

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Stretch-induced hepatic endothelial mechanocrine promotes hepatocyte proliferation.

Our findings indicate that mechanical stretch-induced HB-EGF up-regulation in LSECs via YAP translocation can promote the hepatocyte proliferation during liver regeneration through a mechanocrine manner, which deepens the understanding of the mechanical-biological coupling in liver regeneration.

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J Hepatol

Assessment of liver graft quality during hypothermic oxygenated perfusion: the first international validation study.

This first international study validates the predictive value of the mitochondrial co-factor FMN, released from complex I during HOPE, and may therefore contribute to a better risk stratification of injured livers before implantation. Impact and implications Analysis of 473 perfusates, collected from 10 international centers during hypothermic oxygenated perfusion (HOPE), revealed that mitochondria derived flavin mononucleotide (FMN) values in perfusate is predictive for graft loss, cholangiopathy, and kidney failure after liver transplantation. This result is of high clinical relevance, as recognition of graft quality is urgently needed to improve the safe utilization of marginal livers. Ex-situ machine perfusion approaches, such as HOPE, are therefore likely to increase the number of useable liver grafts.

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Intention-to-treat outcomes of patients with hepatocellular carcinoma receiving immunotherapy before liver transplant: the multicenter VITALITY study.

The first multicenter evaluation of HCC patients receiving ICI pre-LT demonstrates favorable survival and safety outcomes, justifying continued utilization and further evaluation of this strategy in clinical practice. High tumor burden, doubling of AFP levels, and radiographic response were identified as predictors of unfavorable oncologic outcomes. Impact and implications The first multicenter evaluation of pre-transplant immune-checkpoint-inhibitors in hepatocellular carcinoma to show promising intention-to-treat survival, safety and rejection rates. Immune-checkpoint-inhibitors, either alone or combined with LRT, demonstrate reliable efficacy. This preoperative strategy could be particularly beneficial for high-risk patients, including those requiring downstaging or with elevated AFP levels despite locoregional treatment. These findings fill current knowledge gaps and offer reassuring evidence for the feasibility of pre-transplant use of immune-checkpoint-inhibitors, pending results from ongoing trials.

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Non-invasive assessment of severe liver fibrosis in patients with Fontan-associated liver disease: The VALDIG-EASL FONLIVER cohort.

Severe liver fibrosis is prevalent in adults following Fontan-type palliation and can be effectively estimated using with the novel FonLiver risk score. This scoring system can be easily incorporated into the routine assessment of patients with Fontan circulation.

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Targeting PYK2 with heterobifunctional T6BP helps mitigate MASLD and MASH-HCC progression.

Our study revealed a previously unknown mechanism identification of T6BP as a key eliminator of fatty liver strongly contributes to the development of promising therapeutic targets, and the discovery of crucial fragments of T6BP-based pharmacon that interrupt PYK2 dimerization are novel and viable treatments for fatty liver and its advanced symptoms and complications. Impact and implications Excessive high-energy diet ingestion is critical in driving steatohepatitis via regulation of hepatocyte non-receptor tyrosine kinases. The mechanisms under lying the regulation of hepatocyte PYK2 in metabolic dysfunction-associated steatohepatitis (MASH) remain largely unclear. Here, we found that T6BP as a critical fatty liver eliminator has a significant impact on the development of promising therapeutic targets. Additionally, vital T6BP-based pharmacon fragments that impede PYK2 dimerization have been found, offering new and effective treatments for advanced fatty liver symptoms and complications.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: Emulsifiers and thickeners in our food-Do they alter gut permeability?

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Gastroenterology

Intestinal permeability in disorders of gut-brain interaction (DGBI): From bench to bedside.

Additionally, the microbiome's significant role in the communication between the brain and gut has led to the integrative model of a microbiome gut brain axis with reciprocal interactions between brain networks and networks comprised of multiple cells in the gut, including immune cells, enterochromaffin cells, gut microbiota and the derived luminal mediators. This review highlights the techniques for assessment of barrier function, appraises evidence for barrier dysfunction in DGBI including mechanistic studies in humans as well as provides an overview of therapeutic strategies that can be used to directly or indirectly restore barrier function in DGBI patients.

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Portal Fibrosis and the Ductular Reaction: Pathophysiological Role in the Progression of Liver Disease and Translational Opportunities.

Here, we will critically review the latest advances, in terms of mechanisms, pathophysiology, and treatment prospects. In addition, we will delineate future avenues of research including innovative translational opportunities.

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Gut

Targeting TL1A and DR3: the new frontier of anti-cytokine therapy in IBD.

TL1A:DR3 signalling plays a central and multifaceted role in the immunological pathways that underlie intestinal inflammation, such as that observed in IBD. Such evidence provides the foundation for developing pharmaceutical approaches targeting this ligand-receptor pair in IBD.

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Where are we with gastric cancer screening in Europe in 2024?

This paper provides an overview of the recent decisions of the European authorities, the progress towards gastric cancer implementation in Europe and expected challenges. Finally, a potential algorithm for gastric cancer screening in Europe is proposed.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Clin Gastroenterol Hepatol

Clinical Updates in Colon Endoscopic Mucosal Resection.

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Endosc Int Open

Detective flow imaging endoscopic ultrasound for locating optimal puncture site for a poorly vascularized pancreatic mass.

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Endoscopy

Colon polyp surveillance - similar outcomes by size across the histology divide.

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Endoscopic submucosal dissection combined with endoscopic hand-suturing for a superficial esophageal cancer in a diverticulum.

Pubmed   Journal   ReadQx   PMC

Successful removal of a stuck plastic stent in an echoendoscope by additional insertion of a transnasal endoscope.

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Walled-off necrosis treatment: additional evidence.

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Gastroenterology

A Head-to Head Comparison of Risankizumab and Ustekinumab as second line therapy in moderate to severely active Crohn's disease.

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PROTEOMIC BIOMARKERS IN SERUM PREDICT VILLOUS ATROPHY DEVELOPMENT IN ASYMPTOMATIC POTENTIAL CELIAC DISEASE CHILDREN AT TIME OF DIAGNOSIS.

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Pragmatic Resect and Discard Implementation using Computer-assisted Optical Polyp Diagnosis.

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Risankizumab for Induction and Maintenance of Remission in Ulcerative Colitis.

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Tofu-like Disfiguring Colitis.

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Gastrointest Endosc

Application of Functional Lumen Imaging Probe in the Evaluation and Treatment of Anorectal Strictures.

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EUS-Guided Trans-gastric Drainage of Pancreaticopleural Fistula.

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Endoscopic management of appendiceal endometriosis.

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Enteroscopy-Assisted Band Ligation for Hemostasis of Deep Small Bowel Bleeding.

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New Therapeutic Approach for Anastomotic Leaks Following Ileoanal-J-Pouch Construction in Patients with Ulcerative Colitis.

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Submucosal tunneling biopsy is an effective technique for diagnosing malignant esophageal stricture.

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Gut

Cholesterol's new tricks propel MASH-HCC: impact in immunotherapy.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: Emulsifiers and thickeners in our food-Do they alter gut permeability? Authors' reply.

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Letter: Association between terlipressin and multi-drug-resistant organism rectal colonisation.

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Letter: Association between terlipressin and multidrug-resistant organism rectal colonization: Authors' reply.

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Letter: Beyond advanced fibrosis-The critical need for assessing NITs performance in identifying F2-F3 fibrosis.

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Letter: Beyond advanced fibrosis-The critical need for assessing NITs performance in identifying F2-F3 fibrosis. Authors' reply.

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Letter: Bisphosphonate effectiveness in patients with cirrhosis-An emulated clinical trial.

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Letter: Bisphosphonate effectiveness in patients with cirrhosis-an emulated clinical trial. Authors' reply.

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Letter: Dietary emulsifiers and intestinal health-The beginning of an evolving story: Authors' reply.

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Letter: Effect of dietary additives on intestinal barrier and acute stress in healthy adults.

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Letter: Enhancing cirrhosis management-The critical role of social workers in supporting NAFLD surveillance.

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Letter: Enhancing cirrhosis management-The critical role of social workers in supporting NAFLD surveillance: Authors' reply.

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Letter: Social work and clinical synergy-Optimising health interventions for elderly DGBI populations.

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Letter: Social work and clinical synergy-Optimizing health interventions for elderly DGBI populations: Authors' reply.

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Gastroenterology

Comments on "Metabolic Dysfunction-Associated Fibrosis 5 (MAF-5) Score Predicts Liver Fibrosis Risk and Outcome in the General Population With Metabolic Dysfunction".

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Glucagon-like peptide 1 receptor agonists and risk of adverse anesthesia events: caution warranted when interpreting associations with pulmonary aspiration.

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With Great Statistical Power Comes Great Responsibility: Pitfalls of Claims Database Research on the Periprocedural GLP-1 Receptor Agonist Management Debate.

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Gut

AlphaMissense versus laboratory-based pathogenicity prediction of 13 novel missense CPA1 variants from pancreatitis cases.

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Extending inflamed-class signature to predict immune checkpoint inhibitor-based combination therapy in hepatocellular carcinoma.

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Incorporating all the evidence: the role of EGJ-CI in GERD diagnosis.

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J Hepatol

Reply: Implications of Mycophenolate Mofetil in a reproductive age patient cohort: Maternal Fetal Medicine point of view.

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